Evaluation of personal anxiety in patients with myasthenia gravis | Український Медичний Часопис

Kalbus O.I.

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Публікації
Evaluation of personal anxiety in patients with myasthenia gravis

Evaluation of personal anxiety in patients with myasthenia gravis

12 червня 2019

708

Neurology and Psychiatry

Ключові слова :

Спеціальності :

Neurology and Psychiatry

Резюме

Aim — to study the level of personal anxiety (PA) in patients with myasthenia gravis. Materials and methods. 182 patients with myasthenia gravis were examined (147 (80.8%) — with generalized, 35 (19.2%) — with an ocular form). Clinical and neurological examination were performed, the class of myasthenia was determined according to the MGFA, the degree of manifestations of myasthenia was quantitated with the QMG scale. PA was assessed with the Spielberg — Khanin anxiety scale. The levels of antibodies to acetylcholine receptors (AchR-AB) and muscle-specific tyrosine kinase (MuSK-AB) were determined by immunoassay, the detection of antibodies to titin and SOX1 was performed by indirect immunofluorescence. Results. The mean PA level in patients with ocular myasthenia was 44.0 (40.0–47.0) points and corresponded to the moderate level of PA. The mean PA level in patients with generalized myasthenia was significantly higher — 55.0 (48.0–60.0) points (p<0.001) and corresponded to the high PA level. Most patients with ocular myasthenia (60%) had moderate level of PA and most patients with a generalized myasthenia (83.7%) had high level of PA. The increasing in the myasthenia class according to MGFA was significantly accompanied by an increase in PA level (p<0.001). The level of PA correlates with the age of patients (ρ=0.17; p<0.05), with clinical form of myasthenia (ρ=–0.43; p<0.05), with the MGFA class (ρ=–0.2; p<0.05) and the subclass of the disease (ρ=–0.23; p<0.05), with the QMG score (ρ=0.59; p<0.05), with the presence of AchR antibodies and their titre (ρ=0.46; p<0.001 and ρ=0.25; p<0.05 respectively), with antibodies to titin receptors (ρ=0.19; p<0.05). There were no correlation between the level of PA and the presence and titre of antibodies to MuSK (ρ=0.09; p>0.05 and ρ=0.1; p>0.05 respectively), with the presence of antibodies to SOX1 (ρ=0.05; p>0.05). Conclusions. An increase in the degree of clinical manifestations during myasthenia significantly increases the level of PA. This fact must be taken into account when planning a therapeutic tactic for each individual patient.

DOI 10.32471/umj.1680-3051.131.158374

Published: 12.06.2019

References:

Dermanova Y.B. (red.-sost.) (2002) Yssledovanye trevozhnosty (Ch.D. Spylberher, adaptatsyia Yu.L. Khanyn). Dyahnostyka эmotsyonalno-nravstvennoho razvytyia. Sankt-Peterburh, s. 124–126.
Kalbus O.I. (2018a) Kliniko-imunolohichni spivstavlennia u khvorykh na miasteniiu. Ukr. zhurn. med. biol. sport., 1: 135–138.
Kalbus O.I. (2018b) Otsinka tryvozhnosti u khvorykh na miasteniiu. Bukovyn. med. visn., 22(1): 46–51.
Kalbus O.I. (2019) Imunolohichni markery rozvytku miastenii. Ukr. med. chasopys, 2: 24–26 (https://www.umj.com.ua/article/140164).
Kulikova S.L. (2014) Antitela k atsetilholinovyim retseptoram v diagnostike razlichnyih form miastenii. Nevrol. neyrohir. Vost. Evr., 1: 73–82.
Raygorodskiy D.Ya. (red.-sost.) (2001) Prakticheskaya psihodiagnostika. Metodiki i testyi. BAHRAH-M, Samara, 672 s.
Sanadze A.G. (2017) Miasteniya i miastenicheskie sindromyi: Rukovodstvo. GEOTAR-Media, Moskva, 256 s.
Shkolnik V.M., Kalbus A.I., Baranenko A.N., Pogorelov A.V. (2014) Miasteniya: sovremennyie podhodyi k diagnostike i lecheniyu. Ukr. nevrol. zhurn., 2: 12–17.
Andersen J.B., Heldal A.T., Engeland A., Gilhus N.E. (2014) Myasthenia gravis epidemiology in a national cohort; combining multiple disease registries. Acta Neurol. Scand. Suppl., 198: 26–31.
Blum S., Lee D., Gillis D. et al. (2015) Clinical features and impact of myasthenia gravis disease in Australian patients. J. Clin. Neurosci., 22 (7): 1164–1169.
Breiner A., Widdifield J., Katzberg H.D. et al. (2016) Epidemiology of myasthenia gravis in Ontario, Canada. Neuromuscul. Dis., 26(1): 41–46.
Carr A.S., Cardwell C.R., McCarron P.O., McConville J. (2010) A systematic review of population based epidemiological studies in Myasthenia Gravis. BMC Neurol., 10: 46.
Engel A.G. (Ed.) (2012) Myasthenia gravis and myasthenic disorders (2^nd ed.). Oxford University Press, Oxford, 304 p.
Kulaksizoglu I. (2007) Mood and anxiety disorders in patients with myasthenia gravis: aetiology, diagnosis and treatment. CNS Drugs, 21: 473–481.
Skeiea G.O., Apostolskib S., Evolic A. et al. (2010) Guidelines for treatment of autoimmune neuromuscular transmission disorders. Eur. J. Neur., 17: 1–10.